Sudan Journal of Medical Sciences Volume 17, Issue no. 3, DOI 10.18502/sjms.v17i3.12077 Production and Hosting by Knowledge E Editorial “Together We Build Our Health”: Paving Way Forward Through Analyzing the Context and Ensuring Wide Participation in the First and Second Health Forums in Sudan Faihaa A. A. Dafalla1, Heitham Awadalla2, and Nazik Elmalaika Husain3* 1Health Planning Directorate, Federal Ministry of Health, Sudan 2Department of Community Medicine, Faculty of Medicine, University of Khartoum, Sudan 3Department of Pathology, Faculty of Medicine and Health Sciences, Omdurman Islamic University, Sudan ORCID: Faihaa A. A. Dafalla: https://orcid.org/0000-0002-0607-7610 Heitham Awadalla: https://orcid.org/0000-0002-0934-6417 Nazik Elmalaika Husain: https://orcid.org/0000-0001-8333-5735 The health forum is an innovative model for how governments can increase public participation and intersectoral collaboration that could be adapted in other contexts [1]. Toward the end of 2021, the Federal Ministry of Health (FMoH) activated the ”Minister Advisory Council” after four years of dormancy. The council acts as an advisory group to the ministry of health and comprises 20 senior experts in health in Sudan. Together with 26 specialty councils, members proposed to conduct a health forum where the health sector discusses priority issues within the strategic plan. This Sudan Journal of Health Sciences (SJMS) editorial explores the policy process, initial outcomes, lessons learned from these two forums, and the way forward. In March 2022, the FMoH held the first health forum in which the National Health Sector Reform and Recovery Strategic Plan (2022–2024) (NHSRR-SP) was presented. The first forum aimed to develop a catch-up road map for operationalizing the strategic plan to maintain at least the basic health services continuity. In addition, it aimed to ensure the engagement, contribution, and ownership of partners and health profes- sionals. In July 2022, the second health forum was conducted. Its objective was first to ensure the alignment of the forum objectives with the strategic plan, statistically, and second, to ensure that the strategies set before are still valid, if not, then readjust it, as it was preceded by a fluid unstable context. Sudan’s health system is overwhelmed by poverty-associated infectious diseases, nutritional deficiencies, restrictions, economic and management issues, and political instability [2, 3]. Additionally, COVID-19 exhausted the already fragile health system in 2020–2021 while working to prioritize and recover healthcare policies. How to cite this article: Faihaa A. A. Dafalla, Heitham Awadalla, and Nazik Elmalaika Husain* (2022) ““Together We Build Our Health”: Paving Way Forward Through Analyzing the Context and Ensuring Wide Participation in the First and Second Health Forums in Sudan,” Sudan Journal of Medical Sciences, vol. 17, Issue no. 3, pages 287–291. DOI 10.18502/sjms.v17i3.12077 Page 287 Corresponding Author: Nazik Elmalaika Husain; email: nazikelmalaika@oiu.edu.sd, Received 5 September 2022 Accepted 8 September 2022 Published 30 September 2022 Production and Hosting by Knowledge E Dafalla et al. This article is distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use and redistribution provided that the original author and source are credited. Editor-in-Chief: Prof. Nazik Elmalaika Obaid Seid Ahmed Husain, MD, M.Sc, MHPE, PhD http://www.knowledgee.com https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/ Sudan Journal of Medical Sciences Dafalla et al Being pivotal in emergency preparedness, disease/disaster mitigation, and recovery, the FMoH in Sudan prioritized emergency care and primary healthcare to revive the health system to achieve Universal Health Coverage during the early transitional period. Gratefully, it was primarily supported by national and international partners, particularly during the COVID-19 period. However, still, Sudan’s current health status needs more attention. Hence, this forum came to fruition in a noticeably short period under the theme that “we build our health together.” The preparation for the first health forum held on March 1–3, 2022 was extensive. Two committees were formulated; logistic and scientific. The scientific committee was responsible for developing templates, suggesting topics for papers, and reviewing and approving the draft technical papers. The process took more than four months of extensive meetings and technical work. By the time of the event, 17 technical reports across the six strategic projects were documented in a booklet published on the Sudan Health Observatory website [4]. The event concluded with 91 recommendations (Figure 1) for the six strategic projects. It ranged from immediate operational to long-term interventions across the strategic period (up to the end of 2024). Figure 1: Grouping of the recommendations according to the thematic areas of the forum (N = 91). Progress can be seen in the implementation of the 14 recommendations planned beyond the year’s first half (Table 1). In addition, there are other recommendations designed to be in the other quarters. The progress in the performance has varied among the strategic projects, which was understandable given the context. However, the overall DOI 10.18502/sjms.v17i3.12077 Page 288 Sudan Journal of Medical Sciences Dafalla et al Table 1: The progress of the recommendations planned for the second quarter 2022, up to June 2022*. # Theme Recommendation/Task Task progress Theme progress Challenge The way forward 1 Theme one: Governance Establish a mechanism to ensure institutionalization of the long- term vision including the recom- mendation of this forum. 20% 42% Instability at the leadership and senior level. Improvement of the institutional process through development of Institutional quality management system 2 Theme one: Governance Development of comprehensive national M&E plan. 25% Limited number of staff able to work at the development process along with compet- ing priorities. The committees started the revi- sion and update on the existing M&E National Plan in August 2022. 3 Theme one: Governance Assignment of the global health directorate as the focal entity for all the initiated partnerships. 80% – Relocate the coordination desks at the DGGH, HAC, and the states: A meeting with HAC and the states’ representative to agree on the different roles and responsibilities regarding the partnership coordination. 4 Theme one: Governance Activation of coordination mech- anisms, especially intergovern- mental bodies, and creation of joint secretariat for the various coordination mechanisms. 25% Due to the lack of sup- port to the forum secretari- ats from AICS, frequency of meetings to be con- ducted was affected neg- atively. The uncertainty of the political context affec- tive the national forums acti- vation and optimization of their use. Develop a concept note on the joint secretariat role, follow-up mechanism, membership, loca- tion, etc. Decide on the need and feasibility on conducting an NPHCC meeting and arrange as needed. 5 Theme one: Governance Revise the mandates, relation- ships, and structures of the var- ious planning and M&E units at FMoH 30% – To finalize the concept and initi- ate discussion on the suggested arrangements. 6 Theme one: Governance Develop a public–private partner- ship framework (Q4) (10%) – Recruit a consultant and start the process. 7 Theme one: Governance Finalization and adoption of the accountability framework (Q3) (20%) – Reactivate the technical commit- tee and develop the assessment tool. 8 Theme two: PHC Reactivate the existing commit- tee for the death and birth registration. 100% 90% Interruption of the supply of registers to the states. Weak coordination at state level. 9 Theme three: Hospitals Finalization of the hospital sector benefit package. 85% 68% A validation workshop for the benefit package had been conducted but pack- age not finalized. Expected to be finalized by the end of quarter three 2022. 10 Theme three: Hospitals Expand the existing triage system in selected hospitals in selected states 50% Although there are 10 selected states, Aljazeera is not selected, however, it is selected by the strategic plan for the first phase on the demonstration project. Theme four Health security, preparedness, response, and resilience against all hazards with a focus on COVID-19. Nothing for the first six months – 11 Theme 5: Capacities Take the opportunity of donors’ fund to generate the needed evidence for health. 10% 30% Research priorities were not identified yet The research database establish- ment/upgraded through support from donors. DOI 10.18502/sjms.v17i3.12077 Page 289 Sudan Journal of Medical Sciences Dafalla et al Table 1: The progress of the recommendations planned for the second quarter 2022, up to June 2022*. # Theme Recommendation/Task Task progress Theme progress Challenge The way forward 12 Theme five: Capacities To revise and update Sudan Health Observatory website structure and contents 50% Availability of the docu- ments from FMoH and part- ners. The upgrade is planned to take place by the end of the year. To be funded by the government which will enable the use of the government infrastructure. 13 Theme six: Pharmacy Secure sufficient resources and domestic public funding to ensure the availability of essential medicines and vaccines. 0% 20% Economic hardship at the country level. – 14 Theme six: Pharmacy Ensure availability of the lifesav- ing medication. 80% – – 14 Theme six: Pharmacy Activate the national pharmaceutical coordination council to ensure efficiency and effectiveness of the pharmaceutical sector. 0% Technical secretariat needs to be assigned to acti- vate the mechanism and for follow-up. – 16 Theme six: Pharmacy To strengthen the regulatory authority to play its roles. 0% Low resources allocation. – progress is around 49%. Most recommendations progress beyond their timeline (the first three months after the forum). As Table 1 implies, the progress in the Primary Health Care (PHC) and Hospitals themes is good. In contrast, the capacities and pharmaceutical themes need hard work due to sector complexity and the multiplicity of the stakeholders. The main observation in the healthcare system is the fragmentation of the efforts exerted for improvement, causing inefficiency and leading to stagnation in some areas and even deterioration in others. Therefore, the fora call for an active collective and organized effort by all stakeholders to support all parts of the healthcare system strengthening and resilience guided by the strategic plan. In conclusion, the health forums’ theme “Together we build our Health” implies the need for collective efforts beyond the country’s capacities. It is reaching out to everyone and appreciates the efforts of the diaspora around the globe. The theme has extended to the second forum and is expected to last, affirming that health is a shared responsibility that starts with the individual. 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